GENERAL PRACTICE IN MEDICAL EDUCATION: A COMPARATIVE STUDY OF UNDERGRADUATE MEDICAL EDUCATION POLICY DISCOURSE IN BRAZIL AND THE UK

Introduction General Practice´s role in medical education is expanding throughout the world in response to the reorientation of health care from specialized focused hospital care towards generalist primary care. In the countries where demand for primary care services increased, medical schools shifted their medical curricula towards national medical education policies or guidelines that encourage General Practice placements throughout the duration of the course. The objective was to compare the discursive strategies used by medical education policies in Brazil and the UK in regards to the characterisation of General Practice as a field of knowledge throughout history. Method A comparative research design has provided the structure to understand the development of General Practice discourse in both countries. A Foucauldian discourse analysis of medical education policies was conducted to reveal the relationship between knowledge and power. Policies were gathered from the establishment of public national health systems in both countries (Brazil - 1980s and UK - 1940s). Results / Conclusions Each country demonstrates a particular discontinuity of discourses. In the UK, General Practice is gradually reintroduced to medical education: first, as its final product and finally as consultant/specialist equivalent, with gains and losses in its distinguishing characteristics. In Brazil, Family Medicine was first introduced through its absence in the Basic Health Assistance discourse and finally as a new and distinct medical field alienated from its key origins. The study has conducted a deep analysis of the political/economical/social context surrounding the vicissitudes discovered, revealing the power struggles present in the history medical education.